Yanagisawa N
J Electrocardiol. 1981 Jul;14(3):233-8. doi: 10.1016/s0022-0736(81)80004-0.
Electrocardiograms of 3,470 patients, and their 1,430 available radiographs, were reviewed to ascertain the cause of counterclockwise rotation of the QRS complex and of the heart. Seventy-eight patients had the pattern of q in V2, or V3 to V6, and a transitional zone shifted to the right (counterclockwise rotation of the QRS). They all had widening of the aorta, and in the majority the pulmonary artery trunk was not visible by posteroanterior chest radiography. The data suggested that sclerotic lesions of the thoracic aorta are important causes of counterclockwise rotation of the heart and the QRS. Although most patients were in an older age group, cardiac hypertrophy, enlargement, or damage were not found to contribute to the etiology of counterclockwise rotation of the QRS; they may even counteract the development of counterclockwise rotation of either the heart or the QRS axis.
回顾了3470例患者的心电图及其1430份可用的X光片，以确定QRS波群和心脏逆时针旋转的原因。78例患者表现为V2或V3至V6导联出现q波，过渡区右移（QRS波群逆时针旋转）。他们均有主动脉增宽，且大多数患者在后前位胸片上看不到肺动脉主干。数据表明，胸主动脉硬化病变是心脏和QRS波群逆时针旋转的重要原因。尽管大多数患者年龄较大，但未发现心脏肥大、扩大或损伤是QRS波群逆时针旋转病因的因素；它们甚至可能抵消心脏或QRS轴逆时针旋转的发展。
